An Automated Pipeline for the Identification of Liver Tissue in Ultrasound Video

Liver diseases are a leading cause of death worldwide, with an estimated 2 million deaths each year. Causes of liver disease are difficult to ascertain, especially in sub-Saharan Africa where there is a high prevalence of infectious diseases such as hepatitis B and schistosomiasis, along with alcohol use. Point-of-care ultrasound often is used in low-resource settings for diagnosis of liver disease due to its portability and low cost. For classification models that can automatically stage liver disease from ultrasound video, the region of interest is liver tissue. A fully-automated pipeline for liver tissue identification in ultrasound video is presented. Ultrasound video data was collected using a low-cost, portable ultrasound machine in rural areas of Uganda. The pipeline first detects the diaphragm in each ultrasound video frame, then segments the diaphragm to ultimately use this segmentation to infer the position of liver tissue in each frame. This pipeline outperforms directly segmenting liver tissue with an intersection over union of 0.83 compared to 0.62. This pipeline also shows improved results with respect to the ease of clinical interpretation and anticipated clinical utility.